Only a third of nursing services in England are adequately staffed

Most nursing services in England’s healthcare system are understaffed, according to a survey of 11,000 members of the Royal College of Nursing.

Only a third of respondents said there were enough registered nurses working when asked about staffing levels during their most recent shift. the survey found.

There were major staff shortages in both community and hospital settings, with around 33% of hospital services lacking a quarter or more of the registered nurses they needed, and almost 4 in 10 community services up to 50% lacking registered nurses.

This ensures that nurses can care for potentially large numbers of patients at the same time. The RCN said “chronic” staff shortages meant nurses were “often” caring for between 10 and 15 patients at a time.

In emergency rooms, some nurses told the trade association they were caring for more than 51 patients at a time. In outpatient settings, these types of caseloads were ‘consistently’ reported.

Overworked staff in overcrowded environments do not have as much time to spend on individual patients, leading to patient safety concerns.

About 80% of members surveyed told the RCN there were not enough nurses to care for patients safely.

“Nurses are made responsible for dozens at a time, often with complex needs. It is dangerous for patients and demoralizing for nursing staff,” Nicola Ranger, acting general secretary and CEO of RCN, said in a statement. “When patients do not have access to safe care in the community, conditions deteriorate and they end up in hospitals where workforce shortages are just as severe.”

With the UK just two days away from a general election, she called on future leaders to spend more on the nursing workforce and ‘enshrine’ the nurse-patient relationship into law.

England’s public health system has ‘safer workforce’ target levels to ensure shifts are adequately staffed. But these are not legally binding, unlike in neighboring Scotland And Walesboth of which give healthcare providers and commissioners a legal responsibility to ensure safe staff.

Healthcare is a devolved affair in Great Britain, meaning that England, Wales, Scotland and Northern Ireland have different principals, policies and laws.

“We urgently need urgent investment in the nursing workforce, but also for the safety-critical ratio between nurses and patients to be enshrined in law,” Ranger said. “In this way we improve care and prevent patients from being harmed.”

A spokesperson for National Health Service England, which commissions the country’s public health service, told me the agency “has had secure staff guidance in place for several years, so trusts can ensure all patients are treated safely and with adequate care.”

They added: “The NHS continues to invest in our nursing workforce and the latest statistics show there are record numbers of nurses working in healthcare.”

In March this year, there were around 392,900 nurses working in the English healthcare system. About 229,900 of them work in adult and general nursing.

a long-term personnel plan published last summer “aims to increase the number of nurses in training by 80% by 2031/32,” the spokesperson told me. This would mean that the training places would have to be increased to more than 53,500.

There has been a short staffing period a critical issue in the country’s public health services for years. It is a major cause of ongoing healthcare strikes. And it’s a problem that will likely increase as the population grows older and sicker.

Although RCN members voted to end the months-long strikes last spring, other healthcare workers continue to walk out. Junior physicians — roughly equivalent to interns, residents and fellows in the U.S. — wrapped up a five-day hospital strike on Tuesday. It was the eleventh strike by junior doctors since members of the British Medical Association voted to launch industrial action in February 2023.